What Will Happen to Obamacare?

Here's a discussion on how Obama helped/hurt the economy, interesting thoughts inside. Moving past his term, we are about to enter a Trump administration that seeks to repeal (and replace?) Obamacare asap. I hate to keep the focus on politics on WSO, but I feel this is a pretty massive event and I'd love to see your perspective on the matter.

Will Obamacare get repealed (seems like a matter of when if anything)? Will there be a replacement? What would this replacement entail?

 

I'm also torn between being Pro and Anti Obamacare.

From a personal/financial/political standpoint, I'm against Obamacare as it's a huge clusterfuck that will probably be reversed if a republican gets elected that is spending wayyyyyyyy too much taxpayer money on something that isn't necessary, when you're having to reduce budgets in so many other important arenas. Also, as you said, health care in general is going to be increasing even more, so the people without obamacare are getting the shaft again.

From an well since Obamacare exists so why not use it standpoint... I'm Pro Obamacare because my fiance is an assistant at a hair salon and only makes 8 dollars an hour, after subsidies she only has to pay 100 dollars a month for insurance through blue cross blue shield, no deductible, no co pays, no anything. I probably still wouldn't have signed her up for this if it wasn't for the fact that she was just diagnosed with MS and her medication without insurance would be ~4k a month, plus $600 dollar specialist visits, plus MRI's, CAT scans, and bloodwork...

make it hard to spot the general by working like a soldier
 

The idea is good. Healthcare cost are growing too fast...and you need a system to disincentive this.

The implementation is probably going to be bad, because it's the government. However, I am for it because it gets the ball rolling. Future administrations will make change to it, and over time I think it will be a workable program, probably similar to SSN. Will it be perfect, probably no, but it will definitely decrease HC costs.

 

I'm a huge fan of the concept, not so much the execution up until lately. It's an imperfect upgrade to a far more imperfect predecessor system. Change is scary and some people have their reasons for opposing it, so I get that. In the big picture, let's be real, the old system's days were numbered and I think most people understood that on some level, even if they're currently in denial or ideological shock.

They'll get over it.

I look at the hyper efficient auto insurance market and while medical is a vastly larger and more complex beast, it's basically the same thing.

Get busy living
 

It is a social security model and we know how well that is turning out. It is all built on the foundation of young, healthy people signing up to take care of older, unhealthy people. Nothing to combat costs has been implemented and it was sold to the public as being some panacea (which it is not).

Just wait until the penalty starts hitting people, this year and next. You think the outrage over losing insurance or having to pay more is bad, just wait until people get a lower tax return or see that they owe.

Me, I don't care. I just saw my health insurance premium cut in half. If/when the day comes when I need to get my own insurance I will get it. If it is too expensive I will just HSA and get tail insurance for catastrophic issues and simply refuse to pay the "fine". As long as you never get a refund (which I never do) they cannot force you to pay it.

 

Here's the thing: of course you hate Obamacare, you have to implement it. How much do you think the consultants who had to implement SSN, Medicare, Medicaid, etc. hated it? You'll figure it out based on a complex costs/benefits calculation for your clients, and they will adjust eventually.

And what do we get as a society for that adjustment? A significant step closer to universal health care, and a framework for future technocratic policy adjustments that will help bring down costs. If Obamacare isn't bringing down healthcare costs yet, I'm not surprised - it was almost entirely written by health insurance lobbyists, after all, and they have no incentive to bring the prices down on their products. It's much easier to push through technocratic policies that hurt industry bottom-lines as small amendments rather than as part of the major, initial law.

Ultimately, the real problem is that we a private market to handle what is so obviously a public good with enormous externalities. @"UFOinsider", health insurance is not the same thing as car insurance, because of the underlying service. There is essentially infinite demand for health services. For many health services, the demand curve might actually be upward-sloping. In an optimal world, the private market would be either nonexistent or at least small and clearly supplementary - like health insurance for the elderly that supplements Medicare. We would extend Medicare for all, and move toward a single-payer system that makes overwhelmingly more economic, social, and moral sense.

We don't live in an optimal world, but Obamacare is still a significant, if muddled, step forward. Nothing you wrote, OP, seems fundamentally damning, nor anything that could not be either accommodated or modified over time.

 
moosen:

There is essentially infinite demand for health services. For many health services, the demand curve might actually be upward-sloping.

I'm pretty sure you don't understand supply and demand. Simply wanting something isn't demand. Being willing *and* *able* to pay for something is demand. Demand for health services is finite, I assure you.
 

Single payer sounds nice because the accounting is simpler, but there's really no way to incorporate market forces to drive costs down. Europe is dealing with this now and it's going to be very tricky to get out of the hole they've created for themselves. When I was younger and more naive I favored the single payer system. When someone pointed out the mandatory participation exchange, I thought it was brilliant. The gov't sets the minumum standards, and companies compete to provide the most efficient coverage within those parameters.

To all the side arguments against this program, look: private sector insurance has seen less people participating overall and those people end up on the public dole. Hospitals are footing more than their share of the bills, are overcharging to compensate, and then carrying it forward and overcharging because now they can. Insurance companies have enjoyed state/regional monopolies, guaranteeing that the situation doesn't improve....all the while fleecing medical staff of more and more pay.

As far as younger people paying for the older, sure the geriatric crowd can run up the bill infinitely, but so could younger people. Cosmetic surgery, enhancements, sports medicine....our age group could easily run up the bill. The new structure will force an intergenerational dialoge and failing that, open war. The current system just allows older people to take advantage of us. The new system will force the calling of a spade a spade and the conversation looks like this: you're fucking 97, why should we pay a fortune for advanced life support systems to keep you alive for another three months when that money could be used to finance a thousand cancer screenings for people just starting out? FUCK YOU, pay for it yourself.

With the exchange system, hospitals now get pressure to charge less because the insurance company is on their case. The insurance companies have to compete against each other, and that will drive prices down. Doctors will always be paid decently, and yes I'm in favor of gazillion dollar tort reform. I also think we should beat to death the guy that extorted millions of dollars for burning himself on hot fucking coffee. In the longer term, as preventive medical care continues to go mainstream (simple things like the trans fat ban) less money is spent on illness. The good news here is that people don't stop spening money...they switch over to specialty and cosmetic medical focus. We see this in healthy areas and it's well documented. And nothing is stopping doctors from starting private practice in the profitable areas. Also, the broken medical school model we have (if you think it's hunkey dorey, you haven't taken a close look at it) will eventually be forced to change.

This is not perfect, and nothing is. But it's a huge upgrade. In fact, the program finally made its' numbers: http://www.politico.com/story/2014/02/obamacare-finally-clears-the-tower-103468.html

Get busy living
 

I agree with most of Obamacare. There is too much waste in healthcare. The US spends way too much and Obamacare should help bring down the cost and improve the quality.

The only problem with Obamacare is that the Government is implementing it so i don't know if it will ever meet it's intended objectives.

 
seaaMonkey:

I agree with most of Obamacare. There is too much waste in healthcare. The US spends way too much and Obamacare should help bring down the cost and improve the quality.

The only problem with Obamacare is that the Government is implementing it so i don't know if it will ever meet it's intended objectives.

How is Obamacare going to bring the cost down? It simply requires people to have health insurance, thereby increasing the pool of insured to cover everyone else.

Obamacare will simply add to the mountain of never ending US debt. One day we can all look forward to inflation as this is the only way the US debt is going to be handled.

 

Have you taken a close look at this or have you just looked for ways not to like it? There's going to be a huge amount of price re-discovery, as well as drastically reduced prices in the long term now that prophylactics become systemic. The old market was selling to a dwindling band of ideal candidates and by pushing off the disaster cases onto public systems they were merely socializing the costs anyway. A mandated private insurer is almost always going to do better than the straight gov't payer system. At first the expenses go up because now everyone's on the grid...then they go down as the efficiencies kick in. The logic of this is so incredibly simple.....I'm guessing that the people who disagree with it simply don't understand what's going on.

Get busy living
 

I work for a large payer and personally am in favor of Obamacare simply because it's a step forward in healthcare reform. The current system is not sustainable. There's a ton of stupid stuff included in the provisions and the implementation was a complete failure but it's not enough to take it all away. Just fix it over time. There's going to be inherent problems because the government is involved. I don't buy the arguments that it should be repealed because it's forcing people to subsidize the sick or old. Ummm - that's what insurance is (risk pooling). Healthy individuals are getting a "bad" deal by purchasing insurance today but by decreasing the uninsured, it will allow providers to capture what would otherwise be lost revenue. There's a ton of waste in healthcare and the implementation failures have definitely not helped that but it will get much better over time.

Also Obamacare is more than just requiring people to have insurance or pay a fine. There is a huge focus on price transparency because of the shifting of Medicare reimbursement away from fee for service and toward bundled payments. With the focus on cost and quality, providers look at quality more than volume, payers start to setup innovative networks, healthcare services firms develop transparency tools, and patients start reading their EOBs and looking for value in their healthcare. Cost transparency alone is a huge area for cost savings opportunity.

Interested in the healthcare industry? Join our group! http://www.wallstreetoasis.com/group/healthcare
 

i don't know, moosen, in all of the econ classes i took demand curves were a relationship between quantity that people would buy (or sell) and the buying (or selling) price. Q vs. P. how much people wanted to buy but didn't have the resources wasn't ever factored in. maybe i missed class that day?

as for your other statement, that "Markets don't work as well when the price signal is weak. Suppliers tend to pick up excessive profits, and there is less incentive for innovation."....maybe i missed class on this day, too?

In my micro econ classes I was taught that in commodity markets, profits depended on a suppliers costs (e.g. having a price advantage like the saudi's for oil will give you big profits), and also entry costs. If it costs a lot for people to enter the market, then they're let people in the market collect more profits. It isn't until things get really juicy that new entrants will come in if entry costs are high. i don't remember demand elasticity affecting supplier profits...maybe I missed class on this day, too?

one example here is gasoline. assuming you are american, you might complain about gas prices, but likely it doesn't affect you much. i've seen economists cite gasoline purchases as price insensitive, because fuel is a small part of our rich budget, so we drive how we drive anyway. this insensitivity doesn't mean that anyone producing oil is really profitable. those who have higher production costs will have low margin, and those with low production costs will have high margin.

maybe i'm missing something but your arguments don't ring true for me, sir

 

Aside from highly theoretical debates, simple dialogue about what's covered and to what extent is the way forward. In politics, somehow ideologies have taken precedent over discussion of nuts and bolts, and people reason within illusory abstractions in lieu of addressing reality. Here's the deal: the high level is over, the system is up and running.

Now it's just a matter of shaping how it's refined. Discounts for those who actively maintain their health? Punative charges for smokers? You have an idea...throw it in the mix. This is a democratic republic and if you want something you participate. You don't have to run for office or be a gazillionaire to get something done. You just have to make the effort.

I look at google's idea of "iteration". Get something to market, just SEND, and then refine it over time. There's simply no way to get anything this big 'perfect' out of the gate and even if so the conceptualization of what's perfect is going to change with the times.

In a way, the debate is just like that surrounding the FED: a few people are going to kvetch and bitch and moan for the next century, idealizing the world that preceded the systemic overhaul, but perhaps offering an honest critique. A lot of people will argue very minor or esoteric points. Some people will actively try to regress to the old way, and cause immense damage. However, a lot of smart people will actually continue to push for upgrades. Given this is the literal health of a nation, I'm hoping the average citizen gets their head out of their ass and pays attention.

Personally, I'm tired of hearing fat smokers bitch about their insurance, tired of hearing well to do yuppies castigate the working poor for not having employer sponored plans, tired of hearing about the wealthy who can't be bothered with any sense of responsibility, tired of perfectly capable slackers mooching off the public systems, and tired of hearing about "reforms" that are the product of cynical politics. Now everyone begins to be held to account. Again, the system is operational....

You decide your level of participation.

Get busy living
 

I'm fairly sure this is going to get a lot of push back but at the very least consider this idea as ad minimum it will make existing arguments more nuanced and resistant to scrutiny. That being said I would hope that most everyone would come to share this opinion.

The Affordable Healthcare Act as its name implies was created to provide access to more readily available and affordable health coverage. Although well intentioned, it is a classic example of how government often misdiagnoses the symptoms of a systemic problem as the problem itself. True healthcare costs are rising and again true competition is the most effective means of both driving prices down and quality up. However, the root cause of the explosive growth of healthcare cost is not overpaid doctors, new expensive technologies and medical treatments, or the failings of the private sector.

The root cause responsible for health care costs increasing is 1) the third party payer system (medical insurance) 2) hospitals monopolies that effectively lobby congress for protective legislation against competition and 3) the existence of medicare and medicaid. Let me explain further. Perhaps the most potent of these causes is the third party payer system. Proponents of the system claim that insurers bring bargaining power to the table and can therefore negotiate better prices for their patients than an individual ever could. Its true they do possess bargaining power. But they are also much more willing to pay closer to the exorbitant prices charged by hospital so long as they are able to carve out a reasonable profit.

On the other hand if you remove the insurer and patients were paying their doctors and hospitals directly, would they be willing to pay $400 for a saline IV bag? Probably not. If patients were directly responsible for paying for their care the hospitals that charge these astronomical prices (which are the vast majority) would price themselves out of the market place. Am I saying do away with insurance all together? NO ABSOLUTELY NOT. What I am saying is that insurance should be something that we use only in times of extreme medical hardship (i.e. heart attack, cancer, collapsed lung, etc.) Why should medical coverage cover a checkup or prescription? Do we use car insurance to cover the cost of oil changes or a tire rotation? Definitely not. Direct transactions between patients and their care providers mean patients seek VALUE and care providers are forced to compete on BOTH quality of service and cost. The middle man only drives of the cost of care by introducing a third party who needs to find a profit somewhere in the transaction. (SIDE NOTE: Wouldn't you want to directly compensate your doctor? I would over a hospital salaried employee any day. Room for error in a private practice is substantially lower than as a staff doctor at a hospital)

I won't spend much time motivating this point but hospitals (most but not necessarily all) are evil, monolithic entities, with absolutely zero interest in the human patients they "care" for. One need only examine their compensation structure for medical staff to know I'm correct in this case. Doctors, PAs, Nurse Practitioners, and Nurses are all assessed on the productivity levels and rate of production. Some will pause here and ask, "what wrong with that, you seem to be an ultra free market kinda of guy. Why would you care if they do this?" Well I care because one, people are not wiggits, and two quality of care would seem to be a better measure rather than bed occupancy or turnover rate. Further, Hospitals are relentless in there quest to squash any and all competition. It used to be common practice for a physician or group of physicians to form hospitals or start private (for profit) operating rooms. The quality and cost of care was good or they went out of business. Now that practice does still exist but only at a fraction of what it used to. This is not because the industry outgrew these businesses but because hospitals, unable to compete on price or quality of care (as they are "not for profit" and boated with administrative staff in redundant and unproductive roles), lobbied congress to establish protectionist legislation with great success. Also at a personnel level hospital lured competitors from private practice often with lower wages but more security in the form of a salaried position with stead stream of referrals. (Though that's arguably a personal choice and a practice that exists in most industries it's worthy of mention.

Finally, and most contentious of all. The creation of medicare and medicaid, though well intentioned, have played a huge role in driving up the TOTAL cost of care (meaning even care that is not covered by these programs). This is the case because a deluge of patients many of who received free care provided by a hospital or physician (most hospitals had a policy of free care to those unable to afford it. Many physicians to this day still volunteer their services free of charge). We need not get into how poorly run both Medicaid and Medicare are. Obviously their is a need to care for those who cannot afford healthcare. I would never debate that. The question is by what mechanism is that care provided.

In summary, though it is politically unfeasible, the best way to assure quality coverage and affordable prices is to abandon the third party payer system in all but catastrophic insurance. Repeal the anti-competitive legislation that hospitals have effectively lobbied for and restructure existing gov medical programs to reduce costs but increase quality of care (e.g. medical vouchers). The exchanges that the Affordable Health Care Act created are a pale imitation of a true free market exchange and as such will never be as effective. Sadly with the rise of the internet we might have had a true free market solution to the question of individuals seeking medical insurance. Perhaps they could have formed groups, pools of people that could seek insurance coverage at affordable rates by distributing the risk insurers bare across a large number of individuals. The internet could have served as a medium at potentially a fraction of the complexity and cost of the affordable care act.

I hope someone read this and got something out of it.

 

@ Spencer - Really interesting, well thought out and since no one else is going to say it: thank you for representing conservative concerns in an intelligent and accessible way! Ultimately, these issues will overtake rhetoric, so better to start thinking about them now.

The point about the administration of medi-care/caid is basically the case. I'm not sure why it hasn't been farmed out yet. I'm also pretty sure it's a matter of time before it is. As for hospital monopolies, I'm pretty sure that the insurance companies are going to root this out in their cost cutting zeal....they're a much stronger and more trans state (and trans national) power, so they'll quickly cut the hospital lobby down at the knees when it suits them.

As for the very existance of medi-care/caid distorting prices, it's undeniable. The GOP (rightly so) obsesses over it and the left sees it as part of the cost of providing the service (also rightly so). The debate has been gridlocked for a long time by factions arguing for/against the existence of these programs but realistically they will survive. So how to make them work better for cheaper? On the plus side, these programs help a lot of people and prevent a lot of much worse problems. Also on the plus side now, is how ACA is going to be a factor over time in reducing overall costs. The downside is the single payer nature....and sheer MAGNITUDE....of the price distortion ripple that these programs create, affecting every facet of every other thing.

I don't have a solution to offer.

The realistic optimist in me says to be grateful for being able to nail two out of three of the items you've bought up. The theoretical part of me doesn't see a way of actually solving the third yet. Realistically, the programs aren't going away, but there's no reason why they can't be made more efficient and effective. After having given this about one minute of thought, it seems that a number of people could be bought into the ACA program, but it's probably not a large enough number to really fix this. I'm stumped. Way to address the last major problem of health care in the US.

What do you think could be done?

Get busy living
 

Pretty certain they'll knock out at least the individual mandate, with one or two of the other pieces that go along with it. Also, anyone read Scalia's scathing dissent from the Arizona decision? Great read.

Moreover, even if they strike down the individual mandate itself and don't strike down the pre-existing conditions piece people would then not be forced to buy insurance but then they would be able to sign up for insurance any time once they were sick. So They would probably lump all those in together. If that kept together with the restrictions on insurers charging more for medical histories things could certainly get ugly.

 

They'll uphold it under the commerce clause. The logic defending the bill was drafted over the course of several years by some of the most elite lawyers on earth, and they forsaw exactly the arguments that would be made against it.

I'm not for or against the bill and don't know anything about it becaus I've been too busy with work to really pay attention to politics lately. I WILL, however, add the following: the US has a disease management system. That's right: disease management. Cancer, diabetes, heart 'disease'...they are degenerative conditions largely caused by neglect of health. There is no 'heart disease virus', you get it by eating crap and not excercising. But this, and many others, are labelled diseases because it's reflective of the American approach to health.

And we really can do better.

We need a healthcare system. The mechanics...gov't controlled, privately owned, etc...don't interest me as much as the mindset. Whatever takes us closer to having a HEALTHCARE system over a disease, death, and misery mangement system, well, I'm all for it.

I had to get that out there.

Get busy living
 

Mandate gets knocked out 5-4 or 6-3. I'd say there is about a 15% chance the whole bill goes down.

The oral arguments were completely one-sided against the mandate. The lack of a severability clause threatens the entire bill.

UFOinsider:
TThe logic defending the bill was drafted over the course of several years by some of the most elite lawyers on earth, and they forsaw exactly the arguments that would be made against it.
I challenge this. I think many scholars dismissed the potential effectiveness of a constitutional challenge out of arrogance.
 
illiniPride:
UFOinsider:
TThe logic defending the bill was drafted over the course of several years by some of the most elite lawyers on earth, and they forsaw exactly the arguments that would be made against it.
I challenge this. I think many scholars dismissed the potential effectiveness of a constitutional challenge out of arrogance.
I think that the bill was designed around these objections. Agree with the 15% (ish) probability that it gets shot down.
Get busy living
 
TheKing:
As I understand it, the verbal arguments are more for show than anything. The briefs that are submitted are more substantive and thorough and hold far more weight in the decision process.
Your perception of the system is very similar to mine.
Get busy living
 

I think InTrade, being a site full of libertarian traders with money, has a bit of a conservative bias relative to reality (the media has a bit of a liberal bias), but they're right on this count. Obamacare will be overturned by the most Lockneresque court in 75 years.

That said, I think there's money to be made on betting Obama wins in a landslide once this ruling goes through. Gas prices are low. Resources are cheap. We could really use some smart government spending. Let's figure out the nuclear waste situation. I think everyone can agree on that. Build a reprocessing reactor at Yucca Mountain for $50 Billion or however much the environuts say it will cost, and make spent nuclear fuel a non-issue.

 
TheKing:
Conservative heads will fucking explode and they won't even know why!
Sean Hannity will have a fucking conniption. Thing is, everyone's acknowledged ...decades ago... that the health system in America is shitty, but no one will get behind any type of systemic changes or even a pilot program. The medical expertise is there, but the billing and stucturing of diagnostic, prophylactic, and treatment/resource allocation is total chaos. If instead of constantly battling to dismantle/privatize/fragment everything people instead focused on streamlining and upgrading the existing systems, the part of the medical system that's private would actually become more effective and profitable....how much time/money/energy is expended on billing/insurance issues that could easily be standardized? The US will never have a fully socialized program like Europe and we don't need it, but I can definitely say it's time to start making inroads on the current clusterfuck.

Again, I don't know anything about this bill and until yesterday simply haven't followed this issue at all, but it used to be an interest of mine, so, uh, if you have any recommended info sources, it would be much appreciated.

Get busy living
 

Clinton/Gore would've dominated a federal govt. interwebz roll out.

Seriously though, what was the target for people actually completing the enrollment at this point vs the 27,000 they achieved?

This thing could not be more DOA with the young and healthy demo and the advertisements aiming at them are hilarious, especially the one with the slutty chick about birth control.

 
Marcus_Halberstram:

Why is this such a big deal?

Because the goal for enrollments at this point was 500,000 enrollments, not 100,000. They need 7 million enrollments by the end of March for the exchanges to mathematically work, and a decent portion of those enrollments need to be young, healthy people.

The ACA is on the brink of collapse--without the proper enrollment numbers the exchanges will fail. If Congress repeals the part of the ACA law that changes health insurance requirements that would force 50-100 million people out of their current insurance then the entire bill collapses. It's why Jay Carney today said that we shouldn't "throw the baby out with the bathwater" when the media was discussing repeal.

Finally, we've learned that the individual insurance mandate is essentially unenforceable. The entire fundamentals of the ACA are rapidly imploding the entire law. Add on to that the embarrassing website launch and you've got a complete disaster on hand for the Democrats as Obama and Democrats' popularity ratings have completely tanked in the last month. It COULD be setting up the GOP for epic gains in the midterm elections where it already has some very favorable Senate match-ups as well as phenomenal gerrymandering in the Congressional districts.

 
DBCooper:

We are going to single payer anyway. Obama even said to the SEIU in Detroit that is a "transitional step." Who cares? Government is grossly inefficient? Ya don't say....

Well, they had to destroy our current system before introducing a single payer one.

Cue Obamacare...

 

Someone needs to call out Michelle Obama on giving the web development contract to a friend's company. THEN the tech gurus will be called in. I'm all for upgrading the healthcare system through whatever means works and the exchange system is the superior concept but the execution really sucks.

....unless that's the plan. Have the capitalist/state joint system fail so the gov't can take it over completely? I can't see a single payer system surviving in American politics.

In other news, this is the first time that any systemic overhaul of healthcare didn't die in assembly, so there's that. Just get something, anything, on the grid and then perfect it over time. I'm guessing that getting ACA passed into law was the overarching priority considering every other major reform over the last generations hasn't stood a chance. Realistically, Obama has three years to get things up to snuff.

Get busy living
 

Are you delusional? 3 years to clean this up? Try 16 days. The administration has promised that the website exchange would be up and running 100% with no problems by December 1. So you can bet the 1st problem that crops up on December 1 will have people threatening to burn down Washington. If things don't work on December 1 Obama and the Democrats will be done for at least 3 years. Obama is already a lame duck president. If obamacare fails he will no longer be the most powerful person in the country by a long shot.

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 

Have you been paying attention to politics long? What do you think will happen on Dec2? Obama will come out with a white flag and deep six ACA? The GOP is going to mutiny again? God almighty will come down out of the heavens and smite the unrighteous? Maria Bartiromo will save us all?

Nothing will happen.

You know this, I know this, we all know this. Obama will set a new target date ('deadline' in political speak). He will apologize (oh wait, already did). In the words of Jim Carrery in Liar Liar, the GOP will continue "piss and moan like an impotent jerk, and then bend over and take it up the tailpipe!" They can't shut anything down without a suicidal pyrhic victory next year and they know it. Even FOX questioned how Ted Cruz, with his wife's $40K health insurance plan, could go about trying to sabatoge efforts at building a better system for average people.

Obama's apology bought him time but by doing so he also accepted full onus of responsibility for ACA. If it succeeds, Hillary will be president and that's what's really freaking conservatives out. If it fails, Christie will be president, and that's what's driving the 'outrage' over the imperfect start. Do you think the crap hole states down south are actually upset considering they're the largest beneficiaries of public aid? Stop and use your head.

Bottom line, there's a lot of time to fix this. There's an IT consulting FORTUNE to be made here. Insurance companies are playing both sides. Will we see socialized medicine in the US? Doubtful. Plus I think Obama would actually like to see this work. His reputation and ego are on the line. If the GOP wants to continue having a panic attack, let them, but I'm just telling you how it is.

Get busy living
 

Of all the people I've interacted with, you have the least understanding of the vast majority of things that you talk about, and this is no exception.

The Republicans aren't afraid the ACA will succeed--the ACA is guaranteed to fail because the mathematics cannot be overcome. ACA failure is a mathematical certainty.

We know that the individual mandate is virtually unenforceable; therefore, the exchanges will never get the demographic makeup required to make the exchanges economically feasible or affordable. We know that about half of all doctors polled said they won't accept ACA exchange coverage because of the payment schedules, so anyone who has an affordable policy through the ACA will have Medicaid-like garbage coverage. We know that as many as 107 million people will lose their individual plan or their plan through their business or employer due to the insurance mandates. We know that because the insurance mandates require much more coverage the average person is going to pay much more for insurance--only a handful of Northeastern states, such as New York, will see any benefit in costs. Finally, we also know that the ACA is scheduled to cost $2.6 trillion in 10 years when the original estimate was $900 billion--and we can assume that this number will balloon substantially.

It isn't a matter of Republicans fearing that it will be successful. We fear the ACA because its failure is a mathematical certainty, and the Democrats were quoted during the original ACA debate that their plan is to use the ACA as a stepping stone to single-payer. That is their stated plan--pass an unworkable bill and then assert that single-payer is the salvation. The only problem is that the ACA was designed to fail in 10 years, not in 10 months. Now the Democrats are panicking.

 

Hey, believe what you want. Honestly, I think you're so partisan you can't see clearly. Stop and look at what you're saying, and ask yourself if you actually find it plausible....or just want it to be plausible.

Just one example: if the dems want a single payer system (a minority do) then why even bother with ACA? Why wait ten years, if they could have gotten it through congress at this point in time? Setting a program up to fail so they can push another is the GOPs MO. The dems saw this as a compromise. Seriously, cool off and think about the self contradicting tripe you're writing. It makes no sense.

Get busy living
 

I'M so partisan? Your writing could be from the White House press secretary. You called the southern states "crap hole states" (despite the fact that people are flooding into those states from the north...).

It's not me who is saying anything--if you want I will go find you the quotes from the Democrats and liberals where they explicitly state their intentions for the ACA. You think I'm being paranoid? Hilarious. If you ask then I'll go grab the statements. The single-payer system couldn't pass the Democrat Congress because those wicked, evil red state Senators and Congressmen had to do this crazy thing called run for re-election.

Again, the mathematics behind the ACA's success is clear--it's essentially impossible. The bill was designed to fail. It's basic math.

 

I think you're missing the point of what I'm saying. Think hypothetically for a minute. If the gov't is willing to bail out the financial sector to the tune of trillions of dollars, what makes you so sure they won't do the same for the HC sector? If they reconcile the books within three years, they'll call it a success. If not, then the GOP will take over the white house, and big pharma and the insurance companies will assume an iron grip over disease management in the US. It's a binary outcome regardless of how the bean counters want to try to understand it.

Get busy living
 

You assume that the GOP wants insurance and big pharma to 100% control the health care. That is the problem in your analysis. You are making assumptions that quite frankly are binary and not dynamic.

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 

#1 You didn't address anything I just asked. Instead, you rambled about things I didn't say (I don't recall naming you a redneck), you spouted off more stock rhetoric and even used the word "ilk". BWAHAHAHAHA, that actually happened. I like debate, and even if I'm on the losing side I learn something. But I have no use for some twit reading stuff off of Sean Hannity's show and generally being a douche. Seriously, are you high? I feel like I'm talking to a semi-retarded person, or one of those vagrants on the PATH who ramble on about random things. I asked a simple question....do you not have an answer?

I hate doing this, but it has to be done: "what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul."

#2 As an aside, I think the exchange between DCD and Marcus nicely sums up the current civil war within the GOP.

Get busy living
 
UFOinsider:

#1 You didn't address anything I just asked. Instead, you rambled about things I didn't say (I don't recall naming you a redneck), you spouted off more stock rhetoric and even used the word "ilk". BWAHAHAHAHA, that actually happened. I like debate, and even if I'm on the losing side I learn something. But I have no use for some twit reading stuff off of Sean Hannity's show and generally being a douche. Seriously, are you high? I feel like I'm talking to a semi-retarded person, or one of those vagrants on the PATH who ramble on about random things. I asked a simple question....do you not have an answer?

I hate doing this, but it has to be done: "what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul."

#2 As an aside, I think the exchange between DCD and Marcus nicely sums up the current civil war within the GOP.

Let me sum up your response: "Once again I lost a debate to this guy so I'm going to personally attack him."

Bro, once again, you've lost and you've resorted to idiotic posts like this. You and Marcus lose a debate the moment you start attacking "red state crapholes" or calling people trailer park rednecks. That's usually what happens when you don't have the skill or facts to win a debate.

 

Glad to see a discussion on poor ACA enrollment figures devolve into name calling. Plain fact is the majority of Americans, Democrat OR Republicans, are not highly educated and low informed voters. Republicans live in trailer parks, Democrats live in the ghetto, blah blah blah.

The reason why people vote for parties that might be against their best issue is because we have a two party system where you need to decide which issue is most important and go with that. We could have the European system where there are countless parties, but I just see that leading to multiple parties with no real power.

Honestly, we simply need population control.

 

That's kind of the point of this post. I mean if we can't call each other idiots what else do we really have?

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 

Hey, I tried to keep things rational, but after a certain amount of incoherent, rambling name calling, all I can do is make fun of someone.

I like the idea of population control, but stupid people and immigrants insist on multiplying at a rate of two or three times that of the people that know better. Look at it this way: white America is projected to fall to 46% of the population over the next generation. Out of that 46%, I'm going to guess that way more than half will be stupid people. Immigrants will breed because that's pretty much the standard in less developed countries and the first generation brings their values with them. This was explained to me by one of the Mexican cooks at the place I work at on weekends, and there's nothing racist at all about this assessment. They're literally telling us how it is. My family were immigrants and I was one of many. I sure as hell won't have a pile of kids, but that's what immigrants tend to do.

Get busy living
 
UFOinsider:

Hey, I tried to keep things rational, but after a certain amount of incoherent, rambling name calling, all I can do is make fun of someone.

Go ahead and quote the "incoherent, rambling name calling." I challenge you right now to do it. Go ahead. Quote a single incoherent statement or a single "name" that I called you. Go ahead. I'll get the popcorn.

Fact is, you lost the debate. You lost it the moment you intellectually signed on to a mathematically impossible piece of legislation.

 

Another DCDepository/UFOinsider argument, big surprise. Quick, Mewtwo or Mew? Your pick says a lot about your political affiliation.

Only time can tell with these things - just give it a few months and see how the public reacts.

speed boost blaze
 
Magneton:

Another DCDepository/UFOinsider argument, big surprise. Quick, Mewtwo or Mew? Your pick says a lot about your political affiliation.

Only time can tell with these things - just give it a few months and see how the public reacts.

Seriously guys - Mewtwo or Mew?

Where is Flake when you need him/her/it?

speed boost blaze
 

Not really, I'm conservative on some things and liberal on others. It's not an either/or. I like guns but support public health efforts....where's the party that gets those two things right? There isn't. So I have to change each election, person by person. It kind of confuses me that more people don't do this.

Get busy living
 

Honestly, talking to you reminds me of the conversations I used to have with a guy back home who become ridiculously arrogant after being accepted to MENSA. I never told him my IQ, and he assumes he is smarter and therefore permitted to just be rude and nasty. He is not smarter, and even if he were, intelligence is not a substitute for actual knowledge and understanding. But I digress.

"liberal", "ilk", shall I continue? Your arguments are patently false and are borderline incoherent. I asked a question: is not the GOP agenda to gut all regulation, disempower individuals to the point of voting with their declining share of dollars, and depose doctors from decision making via allowing moneyed interests to assume command of the healthcare infrastructure? It's a question. I'm looking for your answer. I have, as of yet, to recieve one.

I grew up in the GOP mindset of "gov't is causing problems" but it has become clear to me that in the absence of any civil participation, the superstructure of healthcare has been coopted by financial firms. All fine and well if it were the best way, but I don't see that it is. The increasing number of people who can't afford it are shown the door to a truly miserable single payer system, to the extent that companies like Micky D's and Walmart are informing their workers how to apply for public assistance. Meanwhile, the gross amount of money spent on healthcare is spiraling out of control and the results continue to be below average at best, downright scary more often. Observe how trans fat is being made illegal only now. It's bad for us? You don't say. This has been known for a long time.

So enter a new system. Poor initial execution, yes, but conceptualy superior. If there's a shortfall, federal money will plug the gap, but the intention is to have it free standing. In fact, I say they didn't go far enough and should amend its charter so that it must become self sustaining just as the post office was for several hundred years before newer (and much more expensive) private technologies evolved.

Hey look, if I'm wrong I'm wrong, but what I'm asking is what is the GOP plan? Not having a plan is ....not governing. If they don't want to do the job, and their shutdown clearly indicated that the current bunch don't, then why not get jobs doing something else? You can't run a country of several hundred million people on the principle of no government. Look at the guilded era and learn for yourself what happened. The communist bastards came in and took advantage of the vaccuum in leadership. You want that? This is perhaps not ideal, but seriously, how do you think this will play out? The psychos in the homeopathy dept have already made inroads as people become increasingly desperate. You don't want to help? Then go do something else. The goal is to build infrastructure that can challenge the gold plated health insurance my employer provides. The difference between people like me and Ted Cruz is that he's got his, and now he wants to make sure others don't. Why? I have no idea. More baby boomer "I got mine now pull up the ladder" crap, selling out the next generation and everyone else.

What exactly IS the republican plan? I had to leave the party when I couldn't see one. It doesn't make me a liberal or any of the other pseudo insults you toss around like some FOX parrot, it makes me a thinking person. Do stock exchanges make Wall Street socialist? Does the minimum requirements for car insurance make it a communist conspiracy? Does the concept that in the richest nation in the history of humanity we can do better then the seriously sub-par system we've seen for the better part of the last century? I say we can. And all I see from the GOP is this total psychological meltdown because 1. they're not in power and 2. they don't understand (or want to) what is trying to be accomplished.

What better idea exactly would the GOP recommend?

Get busy living
 

My arguments are patently false and borderline incoherent? Please provide a single example. One example. One. Just one. You can’t because you’re just making stuff up.

I answered your assertions about what the GOP’s intention was for health care. The answer I presented was clear and you simply ignored it. The answer was that the GOP had no plan for health care other than to break down state monopolies and to reform the tort system. Other than that, the GOP was perfectly content with 100 million people on government health care and 200 million people solely on private health care. We never asked for massive reform. The system did not require massive reform. I will admit that the 5-12 million chronically uninsured U.S. citizens who could not afford or obtain health insurance (due to pre-existing conditions) needed some help. I give the Democrats credit for trying to help them. However, to call the ACA conceptually superior is laughable. It has nothing to do with execution. It has to do with mathematics that are impossible.

 

That no one would sign up. Apparently, people are.

That the democrats want ACA to fail. They do not.

That the goal is for ACA to fail in ten years, and that somehow sooner causes a problem in the ...LOL... conspiracy.

The system works because people buy in. The same people who think ACA can't work are currently the same people who think gold is superior to cash currency. Just today, someone else posted a thread dismantling this misguided idea, but people will believe it.

Look, I don't want to argue with you. Maybe it's because I've given up coffee and just don't have the same level of angst I used to, I dunno. I have no ill will towards you, and I don't even know you. If there's concept to be discussed, great, but I'm beginning to annoy even myself with trying to convince you of anything. Believe what you want.

Get busy living
 

Who has signed up for the ACA? They had almost 1 million people go through the sign up process, of which 1/10 signed up after looking at their options. They need 7 million by the end of March or the math crumbles. That ain't happening outside of a miracle.

Again, I will get you the quotes from the Democrats who said the ACA is a step to single-payer. Their intention IS for the ACA to fail.

I've focused on nothing but the policy here and what the Democrats have said. That's not incoherence--it's verifiable fact.

 

This is a small fraction of the quotes, but these help put the "conspiracy" into context:

Obama said prior to the ACA, “I happen to be a proponent of a single-payer health care program … a single-payer health care plan, a universal health care plan. And that’s what I’d like to see.”

Senator Max Baucus, the chair of the Senate Finance Committee during crafting of the ACA admitted in February 2009 that “There may come a time when we can push for single-payer. At this time, it’s not going to get to first base in Congress.”

Nancy Pelosi in 2009 echoed Baucus’ sentiment: “For 30 years I have supported a single payer plan, but our next best choice is to support an exchange and a public option.”

We know the Democratic leadership's goal was not the ACA, but eventually a single-payer system. A successful ACA would not allow for a single-payer system in the future.

Here is the follow-up to that:

After introducing a public option for 2014, Democrat Representative Paul Grijalva said, “By reintroducing it, we make sure that people don’t forget this is a viable option…. as [Obamacare] is implemented, more and more people are going to come to the realization that cost containment and competition aren’t as robust as they should be, because of the absence of the public option.”

Democrat John Conyers in 2011 after reintroducing single-payer bill after Obama asked for ideas for improvement to the ACA : “Improved and expanded Medicare for all is inevitable in America– it is just a matter of when it will happen.”

http://www.forbes.com/sites/scottatlas/2012/11/25/the-democrats-fallbac…

A strong PROPONENT of Obamacare said the INEVITABLE FAILURE of the ACA is single-payer:

http://www.trevorloudon.com/2013/10/socialist-leader-obamacare-will-fai…

He understood from the beginning that the ACA would fail and yet he supported it.

And the quotes go on and on and on. The fact is, the Democrats' intention was single-payer from the beginning. They didn't have the public support. They passed the ACA as a transition to their ultimate goal. The success of the ACA would mean we never have a single-payer system. Put 2 and 2 together and you have the "conspiracy".

 

If they had wanted to do a single payer system I'm pretty sure they would have just done that and not wasted their political capital. I'm well aware of the evolution of thought. However, I am still unfamiliar with any GOP plan.

Get busy living
 

I actually used to enjoy your debates. But lately it seems that you have merely put your nose up to any points of view other than your own. The fact that you have flat out ignored DCD's mention of the ideas that the GOP put out three separate times in this article alone makes it quite obvious that you hold zero value in anything anyone else says.

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 
UFOinsider:

If they had wanted to do a single payer system I'm pretty sure they would have just done that and not wasted their political capital. I'm well aware of the evolution of thought. However, I am still unfamiliar with any GOP plan.

You think that nationalizing insurers would have gone over well with the majority of the population?

Please don't quote Patrick Bateman.
 

GOP plan: Repeal and replace. Repeal Obamacare and replace it with 1) tort reform; 2) breaking up state insurance monopolies; 3) and a third one is to expand health savings accounts (instead of criminalizing catastrophic health insurance, it should be EXPANDED!).

It won't insure everyone, but it will start to bend the cost curve and it will insure MORE people. I'm sure if the Democrats were open to real reform of the system then the Republicans would be open to discussing how to insure the 5-12 million chronically uninsured.

 

@ heister - my question went unanswered, so I fail to see why I should bend first. Now that it has I can address the answer, and his questions. I DO turn my nose up at the same sad commentary that doesn't seem to evolve. I can only argue the same point so many times before I just think "this person will not listen to reason" and dismiss them. What is the option? To argue with a crazy person is, well, crazy. It is notmy intention to be smug. It is my intention to make someone realize that "wow, they're being stupid and should try thinking a little harder".

@ DBCooper - hence the evolution of thought. If anything, Obama ripped off Romney's idea and the GOP is butthurt.

@ DCD - I'm in favor of tort reform, but it will do nothing to insure substantially more people. It's a good idea, just seperate, and definitely not a substitute. FWIW I'm very glad that John Edwards didn't get the vice presidency back in 2004 given his history of gouging insurance companies of huge tort settlements. If tort is the only reform or taken too far, insurance companies will now have more legal power, and will just sit on the increased profits the way banks did with bailout money. Given there's no current actual crisis, they would quickly be assaulted by the left, leading to further political quagmire. It won't really solve anything in the big picture.

  1. The protectors of state monopolies are the GOP. Why do you think they opted out of the exchange in conservative states? The last thing they're going to do is tamper with their source of campaign donations. Plenty of dems suckle at the teat as well, but they're not holding this up so they can keep that particular gravy train rolling, so I'm hating the dems less than I usually would on this topic. Besides, there's plenty of insurance money advocating for the exchanges. Required signup means increased profits, even if the margins are smaller....which is kind of the point.

  2. HSA accounts aren't insurance. They're savings accounts. At best they're a suppliment to insurance. More often, the account is wiped out very quickly when needed. ALSO, if they're invested in the market, what happens....someone can't get heart surgery because we're in a bear market? An insurance company and other financial services firms are going to do a much more efficient job of managing their portfolio as opposed to every tom dick and harry out there trying to do so. Can you imagine a bailout of Wall Street being needed because one of the underlying motivators is to protect HSA accounts? People's heads would explode.

    If the GOP had a plan, why did they do not much of anything the last decade when they had power? I remember working on Bush's campaign thinking he'd address these problems but then he basically neglected to do his job. From what I see, the plan is "repeal and go back to business as usual".

Get busy living
 

That's the problem, he answered 3 times. You either didn't read his responses or did and ignored what he said. You can't expect people to answer every little point you make and then completely ignore what they say and act like they didn't answer you when they do. Bit hypocritical.

1) Dems would never go after tort reform as the ABA is a huge political donor to democrats.

2) Red states opted out of the exchanges in order to stick it to the administration, any sane person could have told you the healthcare.gov website would have crashed and burned on day 1, I don't think anyone thought it would be only slightly more usable six weeks later.

3) The bill is called The Affordable Care Act, not The Unaffordable Care Act, or The Insure Tens of Millions of Illegals Act, or The Do What I Say Not What I Do Act. In reality the ACA could have and should have been named one of the latter names because those at least are closer to reality.

4) The idea that hey lets stick our hands in a box and reshape $2.5B plus of the yearly economy all at once. That is about as wise as taking apart a modern turbo charged engine with no inkling of how to put it back together, and expecting it to work after you try to put it back together.

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 

1) The alleged goal of the ACA was to expand insurance coverage AND to bend the cost curve. So if bending the cost curve is one of two primary goals of health care reform then tackling malpractice tort (malpractice insurance is the single biggest fixed cost for most medical practices) is absolutely key to bending the cost curve. You could do something as simple capping or eliminating punitive damages or as complicated as creating a whole separate claims system that has a panel of experts review the claims of malpractice, free of lawyers manipulating uninformed juries.

2) I've been over this time and time again, but the Republican Party being a wholly inconsistent and often harmful party IS THE PURPOSE OF CONSERVATISM. I don't care who is at fault--state insurance monopolies are UNCONSTITUTIONAL, and the US Constitution provides power to the federal government to prevent states from criminalizing free trade between states. We conservatives support both states rights and the federal government using its Constitutional authority. This is one of the key powers the federal government has--to allow unconstitutional state monopolies is unconscionable. The University of Minnesota said that eliminating these monopolies is the single best way to expand health insurance to more people.

3) Finally, HSAs are part of what should be a greater reliance on catastrophic health insurance. You pay relatively low insurance premiums to cover catastrophic care with a high deductible; you put away $2500-$5000/year pre-tax into a savings account; you use the money to pay for any out of pocket health expenses; when you reach your deductible then the insurance kicks in. For the vast majority of America this would radically bend the cost curve of health insurance. And any remaining money carries over to the next year and can be inherited by heirs.

ALL of these ideas could have been implemented and it would have bent the cost curve and expanded coverage. Instead, the ACA radically increases costs, bureaucracy, and doesn't even cover that many new people.

The GOP didn't do anything about them because they are an entirely imperfect party run by imperfect men. Even so, not exercising at all is much better for your health than walking off the side of a cliff.

 

Realistically, the numbers are far lower and most of those were very sub par policies with artificially low rates required by '90s HIPPA "reform" that insurance companies compensated for by pushing the cost differential onto group plans. The whole point of ACA was to get a program to law and then refine it over time, as opposed to having it die in committee like every other (maybe better) system has over the last few generations. Given a choice between a rocky start to a better way of doing things vs a rapidly declining status quo, it's kind of a no brainer.

Personally, I don't have to care but I'd like to think my country wasn't run like some 3rd world crap hole.

Get busy living
 

Define sub par policy. This is what pisses me off more than anything. People assuming they know what is better for others. If people want a policy that offers low coverage in exchange for low premiums and high deductibles then that's their right to do so. Why should single men and 60 year old couples be forced to carry insurance that covers births? This is the problem with people with too much education, they feel entitled to tell others that they know better when in reality they have no idea about the circumstances of people in different situations.

Follow the shit your fellow monkeys say @shitWSOsays Life is hard, it's even harder when you're stupid - John Wayne
 

It looks like this administration truly believes that the "wealthy" should pay for all the little projects and fantasies the Dems can come up with.

If the Dems are able to squeeze through a public plan option, it will only be a matter of time until we have full-blown socialized medicine, and once we go down that path there is no going back. Let's all cross our fingers that the GOP and Blue Dog Dems dig their heels in the ground and fight this issue, or else tax rates in the 50+% range will be a must no matter who is in office.

Hope all you "wealthy" analysts didn't have to take out huge student loan bills like I did - I guess those aren't considered when deciding how much wealth a person should spread around so a lazy obese POS or IV drug user with Hep C can get free healthcare and prescription drugs.

 

59%!!! Obama is a fucking jackass. I genuinely hope this drives tax evasion through the roof, I want to see these fucking tools squirm. Making 43 cents on the dollar is disgusting, it's as if you get punished for doing well in life. Wow what a fucking joke, we need to clone Reagan and have him kick some of these fuckers asses.

I blame all the moron Americans who decided to vote with for this waste of space.

 

No wonder the government was playing hardball with Swiss banks. They blocked the escape, now they are ready to suck the blood out of ya, and there's nothing people can do.

 

The government forces us to buy car insurance if we drive. Or is that "optional" because we don't "have" to have a car?

I'm a Republican/Libertarian, but I think the legal challenge has issues when you consider other statutes with similar mandates. There's also a mandate for you to report your income to the government for tax purposes, which costs you money/time. You can make a lot of laws unconstitutional if you take a very literal interpretation of the Constitution.

As far as healthcare, I think forcing people to buy insurance isn't the end of the world, it depends on how the system is implemented and other considerations. That being said, though, I don't trust the US gov. to implement such a system anywhere near as efficiently or cost-effectively as countries with nationalized healthcare. The culture regarding government is totally different.

 

I know at least in my state, you don't HAVE to have insurance. Granted there is a fee associated with not having it which one could obviously construe as being the same as buying insurance but just sayin.

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 

Auto insurance is mandated under financial responsibility law applicable to VEHICLE OWNERS.

The commerce clause cannot be used to justify Obamacare because INACTION is not commerce. Inaction = not buying health insurance.

********************************* “The American father is never seen in London. He passes his life entirely in Wall Street and communicates with his family once a month by means of a telegram in cipher.” - Oscar Wilde
 

You only need auto insurance because if you hurt someone else you need to be able to make them whole. Not having health insurance only hurts you.

This is unconstitutional. I support reforming healthcare and lowering costs, but forcing people to buy health insurance is not how you do it.

 
ANT:
You only need auto insurance because if you hurt someone else you need to be able to make them whole. Not having health insurance only hurts you.
I beg to differ. If someone is bleeding to death in the ER or having a stroke because he/she is not able to be seen due to people without insurance overloading the ERs because their untreated due to lack of insurance infection turned into a major sepsis and they now cannot be turned away without treatment, I would imagine that person is going to feel pretty hurt. Maybe even die. Nevermind the monetary costs of that crap.
More is good, all is better
 

I think the mandate to buy insurance is unconstitutional. The federal government has no power to tax me in lieu of commerce.

But how can some federal judge throw out an entire piece of legislation. Shouldn't republicans be crying about legislating from the bench? I love the diversity in the court rulings. Some judges have ruled it constitutional while others have struck down the entire thing.

I am not cocky, I am confident, and when you tell me I am the best it is a compliment. -Styles P
 

NOOOOO.....

Jackass not know how ER work. ER never say too busy fuck you Tarzan, should have held on to vine. ER makes room for Tarzan Fat Jane in waiting room goes to get 4 bags of chips from vending machine

No one dies in an ER waiting room because the ER is 'busy'. This fact is particularly true in this case as both of the hypothetical patients would go to a trauma center which is designed for stuff like this. I have seen 7 level 3 trauma victims come in within 10 minutes of each other and NOT ONE of them was turned away because the ER was too busy.

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 

Fact of the matter, forcing people to pay for insurance is complete bullshit. People can simply pay the penalty instead of getting insurance and when they need it, sign up for it.

How about cutting costs, deregulating things, opening the market, etc. Reduce costs, don't mandate more things. This is a closet tax, plain and simple.

 
ANT:
FHow about cutting costs, deregulating things, opening the market, etc. Reduce costs, don't mandate more things.

Quit talking that nonsense

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 
ANT:
Fact of the matter, forcing people to pay for insurance is complete bullshit. People can simply pay the penalty instead of getting insurance and when they need it, sign up for it.

How about cutting costs, deregulating things, opening the market, etc. Reduce costs, don't mandate more things. This is a closet tax, plain and simple.

YES +1 to that, exactly how I felt when it was first announced, I prayed it wouldn't get passed for this reason. I am not entirely opposed to higher taxes, but fuck if the administration wants higher taxes then come out and say it, dont dick around with this bullshit and play lets crap on the constitution because we have a 2 year window of opportunity where we run the government and are coming out of a crisis, which we can use to our advantage rather than fix shit that needs a permanent solution (financial regulation, government spending inefficiencies across the map, foreign relations which have gone to shit, etc). O wait, proposing higher taxes is political suicide, big deal suck it up and do what you want to do but have th balls to say it or stay the fuck out of my pocket.

 

ER don't say fuck you Tarzan. ER want to treat Tarzan. ER does not have unlimited doctors and nurses. Doctors and nurses busy saving monkeys.

Maybe you do not live in the area with a high number of people likely to not have insurance. I once took my neighbor (who had insurance) bleeding out of her busted face to ER and we waited for 6 hrs before they even bothered to take her BP or Xray her skull to make sure it's not cracked.

No one dies in ER? http://www.msnbc.msn.com/id/19207050/ns/health-health_care/

More is good, all is better
 

Because bleeding out of your face isn't fatal. Bleeding profusely out of your head, on the other hand, is. Someone died in an ER? I can probably find an article where someone died flying a kite. Doesn't make flying a kite dangerous. I really don't have any interest in debating this with you since one of us worked on an ER and in an ambulance and the other didn't.

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 
happypantsmcgee:
Because bleeding out of your face isn't fatal. Bleeding profusely out of your head, on the other hand, is. Someone died in an ER? I can probably find an article where someone died flying a kite. Doesn't make flying a kite dangerous. I really don't have any interest in debating this with you since one of us worked on an ER and in an ambulance and the other didn't.

Bleeding out of your face isn't fatal, but getting a concussion from the impact that makes your face bleed, and having a growing brain hemmorhage may be. I doubt you worked in ER and on ambulance in any capacity that actually makes you qualified to offer a professional opinion of relevance :) Turns out kites are quite deadly: http://m.timesofindia.com/city/ahmedabad/9-killed-300-hurt-on-Uttarayan…

More is good, all is better
 

I understand the need for people to have healthcare and I honestly lean towards the side that says it is a human right, but I strongly differ in how to go about it. Cost are skyrocketing because there is not price transparency and people don't have skin in the game. Medicare/caid is horribly run with massive cost overages.

Reduce costs, give people incentive to save money, promote prevention rather than cure, promote palliative care instead of ridiculous measures that do nothing but drag out life and cause pain, promote competition and I think prices will come down.

All I know is that forcing people to buy insurance and not fixing anything else will only worsen the problem,

 
ANT:
I understand the need for people to have healthcare and I honestly lean towards the side that says it is a human right, but I strongly differ in how to go about it. Cost are skyrocketing because there is not price transparency and people don't have skin in the game. Medicare/caid is horribly run with massive cost overages.

Reduce costs, give people incentive to save money, promote prevention rather than cure, promote palliative care instead of ridiculous measures that do nothing but drag out life and cause pain, promote competition and I think prices will come down.

All I know is that forcing people to buy insurance and not fixing anything else will only worsen the problem,

First, I'm not singling you out ANT, just using your post because it uses the term "human right".

And maybe this is a topic for another thread but shouldn't it be called "American right"?? Examples include property rights, freedom of speech, etc.

If not ever human has the equivalent right, and we aren't fighting for it, shouldn't we just change the phrase already? Or is that too non-PC? Just wondering.

Regards

"The trouble with our liberal friends is not that they're ignorant, it's just that they know so much that isn't so." - Ronald Reagan
 

Meh, I don't remember the exact count, but every single judge appointed by a Democrat has ruled the law constitutional, while every judge appointed by a Republican has ruled it unconstitutional. I think it might be 2 rulings to 2, but I don't know if that includes today's ruling. Anyway this is a lock for the Supreme Court. Any idiot can predict how 8 of the 9 Justices will rule. In other words, the entire health care system rests in the hands of Anthony Kennedy.

 
EngPhD:
Meh, I don't remember the exact count, but every single judge appointed by a Democrat has ruled the law constitutional, while every judge appointed by a Republican has ruled it unconstitutional. I think it might be 2 rulings to 2, but I don't know if that includes today's ruling. Anyway this is a lock for the Supreme Court. Any idiot can predict how 8 of the 9 Justices will rule. In other words, the entire health care system rests in the hands of Anthony Kennedy.

The conservatives on the court have been some of the biggest proponents of big government and have pushed the supremacy of the commerce clause. Look at the 2005 ruling in regards to marijuana, Gonzales v. Raich; the court set precedent, with that case, that federal law supersedes all state law, even when the commerce is done at one place. Read the hypocrisy of the ruling and you will see what type of moron and amoral huckster Antonin Scalia is. Also, the conservative dominated court has given the federal government the power to steal our land via eminent domain, Kelo v. City of New London.

I am not cocky, I am confident, and when you tell me I am the best it is a compliment. -Styles P
 
LBT:
I would like to propose a home mandate requiring everyone to buy a home, so we can eliminate homelessness.

Way to steal Obama's words right out of his mouth. (Seriously, he said this during the campaign about the single mandate system and it was cited by the judge when he wrote his opinion declaring this unconstitutional).

I know you knew that, just saying it for the good of the group.

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 

I love how you guys argue for mandatory car insurance because you need to make people you affect whole. I dont see how you guys dont see this transfer to health insurance. If I get sick from someone because they do not have health insurance and did not get treated is the same principle. Its because of the externality that individuals dont take into account. It just makes common sense. And saying its unconstitutional is a ridiculous argument against it as its just blindly and literally sticking to something that was agreed upon 200+ years ago, atleast ANT presents some valid arguments that can be debated (ie costs etc but even in that case I would argue that you have to take into account costs as a result of sickness into the equation), but simply coming out and saying its unconstitutional and that is why you wont even consider it is simply ridiculous.

 
derivstrading:
I love how you guys argue for mandatory car insurance because you need to make people you affect whole. I dont see how you guys dont see this transfer to health insurance. If I get sick from someone because they do not have health insurance and did not get treated is the same principle. Its because of the externality that individuals dont take into account. It just makes common sense. And saying its unconstitutional is a ridiculous argument against it as its just blindly and literally sticking to something that was agreed upon 200+ years ago, atleast ANT presents some valid arguments that can be debated (ie costs etc but even in that case I would argue that you have to take into account costs as a result of sickness into the equation), but simply coming out and saying its unconstitutional and that is why you wont even consider it is simply ridiculous.

Universal healthcare isnt going to stop you from getting a cold. What expensive healthcare problems do you get each year that you catch from uninsured people?

 

I am sorry, the constitution an bill of rights are still relevant today and should be revered and followed. Humans don't change. We like to be free. We don't like to be robbed. We like fair trials and being able to defend and express ourselves. We like being able to worship how we like. These things don't change.

Forcing people to pay for insurance is the same thing as taxing them. If healthcare was cheaper, more companies would offer it and more individuals would buy it. Instead of focusing on cost, Obama decides to spread the rape to everyone. Problem is, without focusing on efficiency and people expecting every last ditch effort to be made to keep s alive for an extra week, costs will just sky rocket.

We have insurance for the poor, the old, the young. We need insurance or something like it for the people in the gaps. Maybe a combination aflack and high deductible plan.

I do support regulating health insurance like a utility though. Make insurance companies into steady dividend plays. If an isurance company is expected to make higher profits they will I've to find ways to screw people. If you set it up like a utility they will still make money, but not be expected to make a fortune.

 

The expansions on eminent domain bother the f. Out of me. I can see how the community may need a new road/power line/waterway, but I don't think a specific location for Walmart or a new apartment complex is a necessity.

More is good, all is better
 
Argonaut:
The expansions on eminent domain bother the f. Out of me. I can see how the community may need a new road/power line/waterway, but I don't think a specific location for Walmart or a new apartment complex is a necessity.

Agreed

If I had asked people what they wanted, they would have said faster horses - Henry Ford
 

Requirements to purchase car insurance (or prove financial responsibility) are STATE LAWS.... NOT a federal mandate.

********************************* “The American father is never seen in London. He passes his life entirely in Wall Street and communicates with his family once a month by means of a telegram in cipher.” - Oscar Wilde
 

EMTALA forces hospitals to treat people in the ER regardless of insurance/no insurance, but this mandate is unfunded therefore hospitals are forced to either absorb the cost or shift costs onto the insured. Over half of ER care now goes uncompensated and has put pressure on hospitals to close or consolidate and led to ER overcrowding. You pay the price of the uninsured through higher costs and higher health insurance premiums, not to mention potential lower quality of care due to overcrowding and lack of attention. Part of the reason why purchasing insurance is being mandated is to help lower costs by healthy people paying premiums and offsetting the costs of those who are sick and use the insurance. I can totally see how the commerce clause could be invoked because these hospitals are being forced to provide services and going uncompensated by those without insurance whom they must treat. There isn't any payment for the services rendered.

 
 
CitySophisticate:
EMTALA forces hospitals to treat people in the ER regardless of insurance/no insurance, but this mandate is unfunded therefore hospitals are forced to either absorb the cost or shift costs onto the insured. Over half of ER care now goes uncompensated and has put pressure on hospitals to close or consolidate and led to ER overcrowding. You pay the price of the uninsured through higher costs and higher health insurance premiums, not to mention potential lower quality of care due to overcrowding and lack of attention. Part of the reason why purchasing insurance is being mandated is to help lower costs by healthy people paying premiums and offsetting the costs of those who are sick and use the insurance. I can totally see how the commerce clause could be invoked because these hospitals are being forced to provide services and going uncompensated by those without insurance whom they must treat. There isn't any payment for the services rendered.

Thank you, much more eloquent than my Tarzan goes to ER diatribe :)

More is good, all is better
 

American right probably fits better.

Two ways to go about universal healthcare. Make everyone share the burden and outrageous cost or lower prices so everyone can afford to get healthcare if they want.

Great article in the economist about low cost, high tech machines. Amercans pay out the ass for stuff because we don't are about costs. "insurance will cover it" is out chant. Imagine if we shopped around, denied wasteful services, etc. We could help reduce costs for the insurance company and they would Reece their premium prices. This would benefit companies, they would hire more, it would also make out of work people able to afford insurance.

In the end, people are free to choose. Right now prices are so high they cannot afford to make the decision. If we being prices down, there is no excuse. Government will save money, companies will and so will the individual.

 
Paulson:
Don't hold your breath, it's definitely going to the Supreme Court. However I'm pretty sure the Supreme Court would agree with the Appellate Court's ruling.

No way the SC lets the law stand. It's obviously unconstitutional. (Thankfully the right minded people [Conservatives] outnumber the imbeciles [liberal])

Reality hits you hard, bro...
 

Because me not having health insurance will eventually drive your health care costs up. If I can't afford to go to a doctor for check-ups or wait until it is absolutely unavoidable and wind up in the ER, the hospital will have to offset the cost of my treatment somehow.

Universal healthcare only works if everyone buys into it, whether they want to or not. I understand the reservations some have of the idea of the government forcing you into a contract from craddle to the grave (or penalizing you if you don't), but I don't see any other way of having universal healthcare (unless you guys want to move to a single payer system) in this country.

I can't even begin to predict how the court will rule. I hope it's on the side of decency.

 
HFDreamer:
Because me not having health insurance will eventually drive your health care costs up. If I can't afford to go to a doctor for check-ups or wait until it is absolutely unavoidable and wind up in the ER, the hospital will have to offset the cost of my treatment somehow.

Universal healthcare only works if everyone buys into it, whether they want to or not. I understand the reservations some have of the idea of the government forcing you into a contract from craddle to the grave (or penalizing you if you don't), but I don't see any other way of having universal healthcare (unless you guys want to move to a single payer system) in this country.

I can't even begin to predict how the court will rule. I hope it's on the side of decency.

The constitution is still the supreme law of the land in this country. Ruling in favor of the constitutionality of the individual mandate would be an unprecedented expansion of powers granted under the commerce clause. I don't see how the court could reasonably confine their ruling to the healthcare law. Therefore, I hope the courts strike down the individual mandate.

 

National health insurance is unbelievably misleading. There will be be no connection between what we are going to pay and the actuarial value of what we would be entitled to receive, as there is in private insurance.

You are arguing, broadly, that socialization will somehow reduce costs.

Give me an example of an activity that is conducted more economically by government than by private enterprise.

 

I'm pretty torn on the whole thing and tend to lean against the individual mandate, even if it's a cornerstone of reducing the cost of healthcare over the long-term.

That said, it's pretty entertaining to listen to a guy like Gingrich call it socialism when he touted the same plan in the 1990s.

 

In all seriousness, I would be interested in hearing a really articulate argument against Obamacare in addition to an alternative solution.

The best argument and solution I read was in Griftopia, Matt Taibbi's book. And no, it wasn't socialist crap at all, it was a free market solution. But, I'd be interested in hearing some people on here.

 
TheKing:
Tort reform is literally a drop in the bucket.

The bigger issue is getting rid of the monopoly power held by the health insurance companies.

Bingo. Throw out all the state protectionism and let the insurance co's compete across state lines. They would consolidate, become more efficient and prices will come down. Eventually it would be a lot like auto insurance.

 

I generally dislike the times, but they ran two great pieces on the cost of healthcare:

http://opinionator.blogs.nytimes.com/2011/11/03/less-than-26-billion-do…

http://opinionator.blogs.nytimes.com/2011/11/12/billions-wasted-on-bill…

Aside from these points, I have long felt that the per state insurance market was a relic of another age, like when banks had to incorporate through the states. Competition should at least drive efficiency in private insurance, which could bring overall costs down.

Nevertheless, we ultimately need to just spend less. Doctors have some pretty perverse incentives to prescribe new, more expensive treatments that are not significantly more effective than the old.

Likewise, when costs are shielded from the patient via a HMO, there exists the tendency to over-consume healthcare. How many times have you seen a doctor prescribe antibiotics for a virus, or order an unnecessary test, just to keep a patient happy?

When it comes to the legal aspects of Obamacare, I do not see anything blatantly unconstitutional about the bill. However, this might be stretching the commerce clause too far. I hope the SCOTUS appreciates the public policy ramifications of allowing the individual to become precedent.

The bill itself is a financial time bomb. It was shown as cost effective by collecting additional revenues in 2010-2014. After 2020, costs will explode. This is before considering the potential for abuse created by limiting per-existing condition exclusions.

 

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